Usefulness of optical coherence tomography to distinguish optic neuritis associated with AQP4 or MOG in neuromyelitis optica spectrum disorders

Martínez-Lapiscina, Elena H.; Sepúlveda, María; Torres-Torres, Rubén; Alba-Arbalat, Salut; Llufriú, Sara; Blanco, Yolanda; Guerrero-Zamora, Ana Maria; Solà-Valls, Núria; Ortiz-Pérez, Santiago; Villoslada, Pablo; Sánchez-Dalmau, Bernardo; Sáiz, Albert

doi:10.1177/1756285616655264

Cited by 34 publications

(22 citation statements)

References 12 publications

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“…Of these, 202 articles were selected and assessed for eligibility at the full-text level. After careful evaluation, 35 studies were included that met the inclusion criteria ( 8 , 29 , 30 , 33 , 36 , 39 , 41 , 45 , 47 , 48 , 51 – 54 , 57 , 59 , 63 , 65 , 66 , 68 , 69 , 71 , 72 , 74 – 85 ). The detailed flow chart is presented in Supplementary Figure 9 .…”

Section: Resultsmentioning

confidence: 99%

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; −11.7 μm, 95% CI: −15.2 to −8.3 μm) and macular ganglion cell + inner plexiform layer (GCIPL; −9.0 μm, 95% CI: −12.5 to −5.4 μm) thicknesses compared with MS-ON eyes. Similarly, pRNFL (−11.2 μm, 95% CI: −21.5 to −0.9 μm) and GCIPL (−6.1 μm, 95% CI: −10.8 to −1.3 μm) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: −1.9 μm, 95% CI: −9.1 to 5.4 μm; GCIPL: −2.6 μm, 95% CI: −8.9 to 3.8 μm). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: −0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.

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Section: Resultsmentioning

confidence: 99%

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

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“…Other predictor in this study is the changes of pRNFL thickness in the temporal. pRNFL thinning manifested within 3 to 6 months after acute ON attack, then remained stable [ 16 ]. At 5-year follow-up, we observed particularly thinning in the temporal in patients with final BCVA < 20/400, compared to patients with final BCVA ≥ 20/400.…”

Section: Discussionmentioning

confidence: 99%

Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

Wang

Zhou

Qin

et al. 2017

Journal of Ophthalmology

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Objective This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON) between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years). Results 76 patients (99 eyes) were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years). Vision loss was severe at presentation, with initial best corrected vision activity (BCVA) < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD), 1.3% were diagnosed with multiple sclerosis (MS), 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years) developed NMOSD or MS. Conclusion Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

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“…OCT displays severe damage to the retinal nerve fiber layer and the ganglion cell layer following attacks of optic neuritis in both AQP4 NMOSD and MOG-EM that correlates with visual function and quality of life ( 149 – 158 ). It is currently a matter of debate if retinal damage following optic neuritis is equally severe in AQP4-NMOSD and MOG-EM ( 75 , 77 , 152 , 159 – 162 ) and to which extent structural retinal alterations occur in NMOSD independently of optic neuritis attacks ( 143 , 157 , 163 – 167 ). Although the utility of OCT in patient management requires further investigation, it may help quantify the extent of structural retinal damage following optic neuritis attacks and thus hopefully inform treatment decisions ( 168 – 170 ), and support differential diagnosis in the near future.…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Treatment of NMO Spectrum Disorder and MOG-Encephalomyelitis

et al. 2018

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Neuromyelitis optica spectrum disorders (NMOSD) are autoantibody mediated chronic inflammatory diseases. Serum antibodies (Abs) against the aquaporin-4 water channel lead to recurrent attacks of optic neuritis, myelitis and/or brainstem syndromes. In some patients with symptoms of NMOSD, no AQP4-Abs but Abs against myelin-oligodendrocyte-glycoprotein (MOG) are detectable. These clinical syndromes are now frequently referred to as “MOG-encephalomyelitis” (MOG-EM). Here we give an overview on current recommendations concerning diagnosis of NMOSD and MOG-EM. These include antibody and further laboratory testing, MR imaging and optical coherence tomography. We discuss therapeutic options of acute attacks as well as longterm immunosuppressive treatment, including azathioprine, rituximab, and immunoglobulins.

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Usefulness of optical coherence tomography to distinguish optic neuritis associated with AQP4 or MOG in neuromyelitis optica spectrum disorders

Cited by 34 publications

References 12 publications

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

Diagnosis and Treatment of NMO Spectrum Disorder and MOG-Encephalomyelitis

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